1. Technical Field
This description pertains generally to medical diagnostic quality assessment, and more particularly to medical assessment for radiology and pathology.
2. Background Discussion
The changing landscape of healthcare reimbursement and the shift from fee-for-service to value-based reimbursement have underscored the need to objectively assess the value of information that radiologic interpretations provide within the context of a patient's care. Measures of value may come from the accuracy with which a patient's condition is diagnosed to the time saved to reach the appropriate diagnosis. However, previous studies have demonstrated that approximately 4% of radiological interpretations reported during daily practice contain errors.
Furthermore, variability in radiologist interpretations may exceed 45% among radiologists, as evidenced in a study that compared breast recommendations at accredited medical centers. Current tools for reviewing diagnostic accuracy include RADPEER and RadReview, which are online peer-review systems that score clinical performance based on the completeness of findings, interpretation of the findings, and significance of omissions. Nevertheless, several shortcomings are noted: 1) both peer-review systems do not address variability in interpretation, assuming that another radiologists' findings serves as the “gold-standard”; 2) the process is time consuming, resulting in lost productivity; 3) the criteria for grading may not be clearly defined or followed by reviewers; and 4) the assessment is limited to the information available at the time of interpretation, which does not address the broader question of what value the radiologic interpretation has on the patient's outcome.
Accordingly, an object of the present description is a more objective approach to assessing the quality and utility of radiology reports.